中国血液净化

中国血液净化 ›› 2019, Vol. 18 ›› Issue (08): 524-526.doi: 10.3969/j.issn.1671-4091.2019.08.003

• 临床研究 • 上一篇    下一篇

维持性血液透析患者残余肾功能与症状困扰关系的研究

翁佳敏1,黄碧红1,张炜晨1,陈伟生1,施君1,陈靖1,王梦婧1   

  1. 1. 复旦大学附属华山医院肾内科
  • 收稿日期:2019-01-16 修回日期:2019-05-26 出版日期:2019-08-12 发布日期:2019-08-15
  • 通讯作者: 王梦婧fiyona27@126.com E-mail:fiyona27@126.com
  • 基金资助:
    上海市自然科学基金(16ZR1449400)；国家自然科学基金(81600577)；上海市科委创新行动计划项目(17411950700)；市级医院新兴前沿技术联合攻关项目(SHDC12018111)

The association between residual renal function and symptom burden in maintenance hemodialysis patients

  1. 1Division of Nephrology, Huashan Hospital, Fudan Medical University, Shanghai,200040, China
  • Received:2019-01-16 Revised:2019-05-26 Online:2019-08-12 Published:2019-08-15

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摘要： 【摘要】目的探讨维持性血液透析患者残余肾功能(residual renal function，RRF)变化对症状困扰的影响。方法纳入复旦大学附属华山医院行维持性血液透析患者152 例，根据24h 尿量进行分组：RRF 组(24h 尿量≥200 ml)及无RRF 组(24h 尿量＜200ml)。收集透析相关数据，应用“透析症状指数量表”评估症状困扰，用多因素线性回归及Logistic 回归分析RRF 与症状困扰的关系。结果①症状困扰发生率前5 名：难以熟睡、性欲降低、感觉疲惫和缺乏活力、皮肤干燥、瘙痒。症状困扰严重程度前5 名：骨骼关节疼痛、难以入睡、焦虑、悲伤、便秘。②多因素线性回归发现，残余肾功能与症状困扰严重程度总分呈负相关(t=-2.670；P=0.009)。且RRF 组患者的呕吐、腹泻、不宁腿、足部麻木刺痛、感觉疲惫和缺乏活力、焦虑等症状困扰发生率低(OR 值分别为0.071，0.064，0.053，0.123，0.187，0.132；Z 值分别为- 2.200，- 2.130，- 2.260，- 2.540，- 2.920，- 2.410；P 值分别为0.028，0.033，0.024，0.011，0.003，0.016)。结论有残余肾功能的血液透析患者症状困扰严重程度更低。

关键词: 维持性血液透析, 残余肾功能, 症状困扰

Abstract:

【Abstract】Objective To explore the association between residual renal function (RRF) and symptom burden in maintenance hemodialysis (MHD) patients. Methods A total of 152 MHD patients were enrolled in this study. Patients were divided into two groups according to urine volume. Their dialysis related data were collected. Symptom burden was evaluated by Dialysis Symptom Index. Multvariate liner regression and multivariate logistic regression analyses were used for exploring the association between RRF and symptom burden. Results ①The burdens of top five occurred symptoms were trouble staying asleep, decreased libido, tired, dry skin and itching. The burdens of top five severe symptoms were bone or joint pain, insomnia, anxious, sad and constipation. ②Multivariate linear regression revealed that RRF was negatively correlated with the total score of symptoms (t=-2.670, P=0.009) and patients with RRF had lower prevalence of several symptom burdens, including the burdens of vomiting (OR=0.071, z=- 2.200, P=0.028), diarrhea (OR=0.064, z=-2.130, P=0.033), restless legs (OR=0.053, z=-2.260, P=0.024), foot numbness and tingling (OR=0.123, z=-2.540, P=0.011), tired (OR=0.187, z=-2.920, P=0.003) and anxious (OR=0.132, z=-2.410, P=0.016). Conclusion MHD patients with RRF had less symptom burdens.

Key words: Maintenance hemodialysis, Residual renal function, Symptom burden

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